Most people feel low or down from time to time, but this is not the same as being depressed. Depression is a condition that lasts for longer periods. A number of feelings, such as sadness and hopelessness, dominate a person’s life and make it difficult for them to cope. People with depression may also experience physical symptoms, such as loss of energy and appetite changes. Physical symptoms of depression are more common in older people with the condition.
At least one in five people in the UK will experience depression at some time in their lives. It is more common among people with dementia (20–40% of whom may have depression), particularly those who have vascular dementia or Parkinson’s disease dementia. Depression is often diagnosed in the early stages of dementia, but it may come and go, and may be present at any stage. Depression is also common among family carers supporting a person with dementia.
What are the symptoms of depression?
Depression affects people in different ways and to different degrees. Doctors may talk about mild, moderate and severe depression. Some of the more common symptoms include:
- a sad, hopeless or irritable mood for much of the time
- a loss of interest or pleasure in activities that were once enjoyed
- feelings of low self-esteem, worthlessness or undue guilt
- feelings of isolation and of being cut off from other people
- sleep disturbance, such as early morning waking
- problems with remembering, concentrating or making simple decisions
- increased agitation and restlessness
- tiredness or loss of energy
- eating too little or too much, with weight loss or gain
- aches and pains that appear to have no physical cause
- thoughts of death and suicide.
Some of these symptoms (such as problems with memory or concentrating, and withdrawal) are similar to those experienced by people with dementia. This is why assessment of someone for possible dementia will usually include ruling out depression first, in case depression alone, rather than dementia, is causing their symptoms.
A person with both dementia and depression will be struggling with two lots of difficulties. They may find it even harder to remember things and may be more confused or withdrawn. Depression may also make behavioural changes worse in people with dementia, causing aggression, problems sleeping or refusal to eat. In the later stages of dementia, depression tends to show itself in the form of depressive ‘signs’, such as tearfulness and weight loss.